Uterine artery pseudoaneurysm: not a rare condition occurring after non-traumatic delivery or non-traumatic abortion

• Published in: Archives of gynecology and obstetrics Vol. 290; no. 3; pp. 435 - 440
• Main Authors: Baba, Yosuke, Matsubara, Shigeki, Kuwata, Tomoyuki, Ohkuchi, Akihide, Usui, Rie, Saruyama, Miyuki, Nakata, Manabu, Suzuki, Mitsuaki
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2014; Springer Nature B.V
• Subjects: Abortion, Induced - adverse effects; Abortion, Induced - statistics & numerical data; Adult; Aneurysm, False - diagnosis; Aneurysm, False - therapy; Delivery, Obstetric - adverse effects; Delivery, Obstetric - statistics & numerical data; Diagnostic Imaging; Endocrinology; Female; Gynecology; Hemorrhage; Human Genetics; Humans; Hysterectomy; Maternal-Fetal Medicine; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Postpartum Hemorrhage - therapy; Pregnancy; Retrospective Studies; Uterine Artery; Uterine Artery Embolization; Uterine Hemorrhage - etiology; Uterine Hemorrhage - therapy; Veins & arteries; Young Adult; Uterine artery pseudoaneurysm; Cesarean section; Pseudoaneurysm; Postabortal hemorrhage; Postpartum hemorrhage
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-014-3226-4

Purpose Uterine artery pseudoaneurysm (UAP) is considered a rare disorder after traumatic delivery or traumatic pregnancy termination such as cesarean section or dilatation and curettage, initially manifesting as genital hemorrhage. Our clinical impression contradicts these three assumptions; after traumatic delivery/termination, hemorrhage, and its rarity. Thus, we attempted to clarify these three issues. Methods We retrospectively analyzed 22 UAP cases treated at our institute over a 6-year period. Results Uterine artery pseudoaneurysm occurred in 2–3/1,000 deliveries. Of 22 cases, half occurred after non-traumatic deliveries or non-traumatic pregnancy termination. Fifty-five percent (12/22) showed no hemorrhage; ultrasound or color Doppler revealed UAP. Thus, half of UAP occurred after non-traumatic deliveries or non-traumatic pregnancy termination and showed no hemorrhage at the time of their diagnoses. All patients received transarterial embolization, which stopped blood flow into UAP or achieved hemostasis. Conclusion We must be aware that UAP may not be so rare and it may be present in patients after non-traumatic deliveries/pregnancy termination and without postpartum or postabortal hemorrhage.